State warns of ‘major’ vacancies in agency overseeing services for vulnerable populations

The state agency charged with overseeing services to Nevadans with disabilities or special health care needs is facing “major vacancy rates,” with the largest shortfall among social workers and specialists who provide oversight to state long-term care facilities, lawmakers were told Wednesday. 

The Aging and Disability Division, which is part of the Nevada Department of Health and Human Services, told the Interim Legislative Committee on Seniors, Veterans and Adults with Special Needs that nearly one in four of the division’s authorized positions are unfilled.

The adult protective services and long-term care ombudsman office, which provides oversight and advocacy for people living in residential facilities, has a 44% vacancy rate, while the home and community based services has a 47% vacancy. 

The legislature approved funding for 164 positions for the ombudsman office and 209 for home and community services, but there are 72 and 99 vacancies respectively. 

“The majority for the teams that have the largest vacancy rates are social workers, which continues to be an ongoing challenge for our division,” said Jeffrey Duncan, the agency manager for the Aging and Disability Division.

Though social workers made up a significant portion of vacancies, Duncan said the long term care ombudsman lacked “adult rights specialists.”

When the ombudsman’s office receives complaints from people living at a residential facility or their loved ones, adult rights specialists “are the ones who advocate on their behalf,” Duncan said.  

“They also do unannounced site visits to the long term care facilities,” he added.

Democratic State Sen. Pat Spearman, the committee chair, noted that in previous sessions lawmakers have passed legislation to “create enhanced penalties for anyone who was receiving maltreatment over the age of 60.”

“I’m looking at the 44% vacancy rate,” Spearman said. “Do you have enough people to make sure those who are perpetrators of that (maltreatment) are brought to justice?” 

Duncan said enforcement is not under his supervision, and so he wasn’t able to answer the question. But the understaffing “definitely heightens the amount of people each social worker and team is responsible for investigating.”

“If I was to say this on their behalf, we would love to get all our vacancy rates addressed so we can continue to provide quality services to individuals and not increase caseloads,” he said. 

State officials told lawmakers the top challenges are not being able to offer competitive salaries compared to the private sector or even county social services agencies. 

“The other thing is quite simple: there aren’t enough social workers in the state,” said Carrie Embree,who oversees the state Office of Consumer Health Assistance.

Duncan said the Aging and Disability Division has “had some success recently to get people hired” but is still struggling. 

The division, he said, was looking to make a job offer for the vacant position of attorney for the rights of older persons and persons with a physical disability or intellectual disability.

The position, part of the protection and advocacy program, directs the agency’s legislative and regulatory policies.  

Other short-staffed programs include Nevada Early Intervention Services, which provides services to families with children diagnosed with a disability or developmental delay. The program has a 16% vacancy rate, with 32 unfilled positions. 

The Office of Consumer Health Assistance, which can assist with resolving disputes between out-of-network health providers, has a 27% vacancy rate while the communication access services reports a 25% vacancy. 

While the current lack of personnel puts a strain on the division’s workload, Spearman worried that as the population gets older things might get worse. 

Nevada, she said, has one of the fastest growing “graying populations,” adding that this year for the first time the population for those 55 and older is projected to outnumber those who are 54 and under.

“I look at the staffing vacancies and some of the other things brought to our attention, I’m not so sure we are ready for that,” Spearman said.